Ceftriaxone remains the mainstay of treatment for Neisseria gonorrhoeae infection, with no first-line alternatives at this stage. In Australia, since 2017, there have been four documented ceftriaxone-resistant N. gonorrhoeae infections. These involved two infections with the FC428 strain in 2017 (which has since been demonstrated to have spread globally from an unknown geographical source),1,2 followed by two infections with the A2543 strain in 2018, which also exhibited high-level resistance to azithromycin (.256 mg/L).3–5 Both FC428 and A2543 strains harbour the penA60.001 allele encoding key PBP2 alterations, A311V and T483S, associated with ceftriaxone resistance.5 Three of the four infections reported in Australia were travel associated; all were detected by bacterial culture and considered sporadic.
- Molecular Surveillance
- Resistant Gonorrhoea